Symptoms and signs of menopause

Menopause symptoms and the associated signs of menopause are part of a woman’s natural reproductive cycle.
During the early teens, your ovaries will start releasing an egg every month. If the egg is fertilized, pregnancy occurs. If there is no fertilization the egg dies. The uterine lining (endometrium) which was built up in preparation for pregnancy, breaks down and is shed - menstruation.There are 4 main hormones involved in the menstrual cycle:

  1. estrogen
  2. progesterone
  3. follicle stimulating hormone (FSH)
  4. luteinizing hormone (LH)

The two that concern you most with regard to signs of menopause and symptoms of menopause are estrogen and progesterone. The menstrual cycle can be divided into 3 parts:

  1. pre-ovulation
  2. post-ovulation
  3. menstruation

In the pre-ovulatory phase, the developing egg releases estrogen predominantly. This causes the endometrium to proliferate and thicken. In the post ovulatory phase, progesterone is secreted in increasing amounts from the corpus luteum which is left in the ovary after ovulation.
It acts to increase the blood supply to the endometrium making it water-logged and rich in nutrients. If pregnancy does not occur, the corpus luteum dies through lack of stimulation from a growing fetus. Following this, the secretion of estrogen and progesterone declines. The endometrium does not have enough hormonal stimulation to thrive and starts to break down shedding the top 2 layers and leaving the basal layer intact. This is referred to as menstruation. In the absence of pregnancy, this cycle occurs roughly every month (22-35 days).
There is a limited number of eggs in the ovaries and as you get older, more and more of them die off. By the time you’re in your 40s, most of the eggs have been released during ovulation or died and the few that are left are usually of poor quality. Ovulation may not occur every month and the length of the menstrual cycle gradually increases. Menstruation becomes irregular until eventually periods stop altogether.
 During this time of irregular ovulation/menstruation, there is marked fluctuation in estrogen and progesterone levels. Estrogen levels tend to be higher than those of progesterone, leading to the use of the term ‘estrogen dominance‘ to describe this imbalance. Without a corpus luteum there is minimal secretion of progesterone. However, estrogen is still produced (in the fat cell for example) from conversion of androgens (male sex hormones) produced by the ovaries and adrenal glands. Menopause symptoms and menopause signs are thus caused by several factors:

  1. imbalance between estrogen and progesterone
  2. progesterone deficiency
  3. estrogen deficiency

The following list of menopause symptoms and menopause signs is very long and far from exhaustive. Fortunately, no woman will have all the menopause symptoms and signs and some women are fortunate enough to have relatively mild menopause symptoms.

  • hot flashes (the most common menopause symptom, affecting about 85% of women)
  • depression
  • forgetfulness
  • headaches
  • inability to concentrate
  • irritability
  • mood swings
  • chest pain
  • palpitations
  • sore breasts
  • irregular/heavy bleeding
  • vaginal dryness
  • itchy vulva
  • loss of sex drive
  • slower sexual arousal
  • painful intercourse
  • constipation
  • abdominal bloating
  • irritable bladder
  • frequent bladder infection
  • frequent urination
  • increased facial hair
  • thinning hair
  • itchy skin
  • brittle nails
  • pins and needles
  • sore muscles
  • stiff/swollen joints
  • back pain

These menopause symptoms occur at various times. Early symptoms of menopause include irregular or heavy vaginal bleeding while menopause symptoms like thinning of the hair and brittle nails may not occur for several years after the menopause.

December 5, 2008 by Ada
Filed under: Menopause symptoms, Progesterone 

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Comments

9 Comments on Symptoms and signs of menopause

  1. Kelli Froscher on Tue, 26th Jun 2007 11:05 am

    2. I actually have a question. I’m 44 and ttc. My nipples are sore and I ovulated 2 days ago. Is this a post-ovulation symptom? I really need to know so I don’t get my hopes up. Thank you for your reply.

  2. Ada on Tue, 26th Jun 2007 7:34 pm

    3. Hi Kelly. I know it must be a little difficult waiting to see if your period is going to turn up each month, don’t lose hope.
    Out of curiosity, I just wanted to ask how you know that you ovulated 2 days ago.
    As for the sore nipples, there is the tendency for them to be sore in the second half of the menstrual cycle because of increased levels of progesterone. Progesterone causes water retention which can lead to sensitivity and soreness. That said, 2 days after ovulation is too early to know if you’re pregnant. Difficult as it may be, just give it a little time. If it happens, there’s no way you won’t find out eventually.
    Take care.

  3. Izzy on Sat, 21st Jul 2007 1:58 am

    4. Since the birth of my first child, when i was 34, I have had many symptoms of menopause.

    I was put on an estrogen patch and birth control pills, which have helped tremendously but the few times Ihave tried to go off my pills or been late putting on my patch, the symptoms come right back. The main ones are sore muscles/muscle tension, stiff, achy joints, vaginal dryness, heart palpitations and extreme irritability.

    My ob/midwife says that it’s not widely talked about but that it’s not uncommon for your hormones to be permanently altered after childbirth and that she sees a number of women in the same boat as me.

    I’ve never heard of this and have only met one other woman who was having the same exact problems. Have you heard of this happening after childbirth?

    Incidentally, by going off birth control but staying on my patch, I was able to conceive and have another child but I still have the same menopausal symptoms if I’m not vigilant with the patch.

    The doctor who originally prescribed the patch/pill combo for me said I had premature ovarian failure but my progesterone levels were always very normal. If my ovaries were failing, wouldn’t all ovarian hormones be low, not just estrogen?

    Sorry for this long comment and all the questions. it’s just that after seven years, I’m still confused about all of this and wish i knew what was wrong with me.

  4. Ada on Sat, 21st Jul 2007 8:09 pm

    5. Hi Izzy. I know how frustrating this kind of thing can be. It’s difficult to give you a definite answer because your doctor and Ob/midwife who have been attending to you will have a more accurate idea about what’s going on.
    There are a couple of things I can tell you though.

    1. You can divide ovarian failure into 4 stages with grade 1 being the mildest. This is also known as occult (hidden) ovarian failure where you may have regular menstruation and still experience hot flashes and other menoause symptoms.
    2. Ovarian failure sometimes becomes apparent after pregnancy or coming off oral contraceptives.
    3. Women with ovarian failure may still ovulate once in a while and so pregnancy is not impossible but they do tend to have infertility.
    4. If you ovulate, you will have progesterone in your circulation

    Like I said, I’m assuming you actually do have ovarian failure because your doctor is in the best position to know what’s going on.
    You managed to conceive? You’re really blessed!
    Take care.

  5. Izzy on Sun, 22nd Jul 2007 5:07 am

    6. Conception has never been a problem for me (pregnant three times on the very first try) and according to the ovulation scope I use each month to, ironically, make sure I don’t get pregnant, I ovulate regularly (and even since all this started, FSH has always been normal) although now that I’m approaching 40, I expect that will start to change.

    To be honest, I don’t think I have POV. The only other possibility that was mentioned was PCOS although other than a couple of weird, wiry chin hairs, I have absolutely no symptoms or signs and believe me, I’ve had enough bloodwork for three lifetimes…lol

    Thanks for your help :)

  6. heather lynne on Wed, 15th Aug 2007 1:23 am

    7. hello there, i am 41, and have been in menopause since i was 37, i was allite disappointed at first, but , i was blessed to be able to concieve two kids, i do however sometimes feel like iam ovulating sometime, and can you still get discharges related ot you cycle, i do get a llittle linning build up so the gyno put me on drug to take only twice a year to shed it , to keep me from getting uterin cancer, oh yes , i did have one of my ovary removed at a 10, because of a tumor, would this have any bearing on my early meno, oh guess what girls , there is one good thing about menopause, no more very painful periods, and no more stinking, awful blood, but i want more kids though, can i still do it thanks heather

  7. Jennifer Curran on Tue, 30th Dec 2008 6:17 pm

    8. I’ve also noticed that my skin has been affected as I reach a menopause age. Is it natural to have scaly skin as a result of menopause?

  8. internetten para on Sun, 18th Jan 2009 6:49 pm

    9. Very informative, good article .thank you

  9. Music_Mp3_boabbestesauh on Thu, 5th Feb 2009 8:36 am

    10. Hello to all :) I can’t understand how to add your site in my rss reader. Help me, please

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